- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $106.53 / $1,823.00 / $3,363.00
| Facility | | $106.53 | $1,823.00 | $3,363.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $102.04 / $164.96 / $278.08
| Professional | | $102.04 | $164.96 | $278.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $327.32 / $2,410.09 / $12,000.00
| Facility | | $327.32 | $2,410.09 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $154.69 / $337.67 / $1,561.20
| Professional | | $154.69 | $337.67 | $1,561.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.96 / $199.12 / $355.17
| Facility | | $154.96 | $199.12 | $355.17 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $633.32 / $1,695.28 / $1,695.28
| Professional | | $633.32 | $1,695.28 | $1,695.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $443.00 / $500.00 / $3,111.82
| Facility | | $443.00 | $500.00 | $3,111.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $135.01 / $270.00 / $582.01
| Professional | | $135.01 | $270.00 | $582.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $105.39 / $377.00 / $6,679.00
| Facility | | $105.39 | $377.00 | $6,679.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $253.24 / $328.32 / $474.24
| Professional | | $253.24 | $328.32 | $474.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $157.44 / $290.24 / $601.09
| Professional | | $157.44 | $290.24 | $601.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $595.50 / $2,854.00 / $12,000.00
| Facility | | $595.50 | $2,854.00 | $12,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $225.99 / $538.92 / $1,561.20
| Professional | | $225.99 | $538.92 | $1,561.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,061.00 / $2,854.00 / $5,714.00
| Facility | | $1,061.00 | $2,854.00 | $5,714.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $204.18 / $337.67 / $714.36
| Professional | | $204.18 | $337.67 | $714.36 |